Front-End Partner Registration Form

To be filled by Partner for CYNIX Authorization. Please fill all required fields marked with an asterisk (*).

Company Details
Business & Capability

Financial Performance
Operational Coverage

Categories & Territory
Contact Details

Key Contacts
Submit

Attachments & Declaration

Company Details

Firm Name *

Constitution *

Incorporation Date *

Registered Address *

Company Territory / States / Cities *

Company States *

Company Cities *

PAN Number

GST Number

GeM Seller ID *

GeM Seller Rating (1-5)

Company Email ID *

Contact Number *

Website

Business & Capability Details

Last 3 Years Turnover *

Last Year GeM Turnover (₹ Cr) *

Last Year GeM L1 Sales Turnover (₹ Cr)

Operational & Coverage Details

Product Categories for Authorization *

Hold Ctrl/Cmd to select multiple options

Preferred Territory / Region *

Select All Territories

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States *

Select All States

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Cities *

Select All Cities

Hold Ctrl/Cmd to select multiple options

Top 5 Categories Currently Selling on GeM (Optional)

Top 5 States Currently Selling on GeM (Optional)

Top 5 Brands Currently Selling on GeM (Optional)

Primary Contact Details

4.1 Promoter / CEO / Proprietor

Name *

Mobile Number *

Email ID *

4.2 Sales Head

Name *

Mobile Number *

Email ID *

4.3 GeM Sales Executive

Name *

Mobile Number *

Email ID *

Attachments & Declaration

GST Certificate (PDF) *

Last 3 Years Turnover Certificate (PDF) *

I hereby declare that the information provided above is true and correct. I understand that CYNIX reserves the right to approve, reject, suspend, or re-authorize the partnership at its discretion. *